Medicaid merits a vote

Saturday

Jul 6, 2013 at 12:01 AMJul 7, 2013 at 10:54 AM

When Gov. John Kasich vetoed a state-budget provision that would prohibit expanding Medicaid, he kept alive the effort to provide health insurance to 275,000 Ohioans who currently lack coverage, with premiums largely paid by the federal government.

When Gov. John Kasich vetoed a state-budget provision that would prohibit expanding Medicaid, he kept alive the effort to provide health insurance to 275,000 Ohioans who currently lack coverage, with premiums largely paid by the federal government.

Lawmakers erred in at least two ways on Medicaid expansion: first, by rejecting Kasich’s plan to expand it, then by trying to prohibit any further attempts to launch it.

The arguments in favor of expansion are numerous and clear. The only arguments against it are based in stubborn ideology: Some GOP lawmakers don’t like the federal Affordable Care Act, which underpins the expansion, and they don’t approve of any more federal spending.

In numerous editorials, The Dispatch has exposed the very serious flaws of the Affordable Care Act and agrees with critics of the law. But the fight against it is over. Congress passed it, the president signed it into law and the U.S. Supreme Court gave its blessing.

One doesn’t have to like it in order to acknowledge that it is reality.

And arbitrarily turning away the federal dollars promised by the Medicaid expansion would make no appreciable dent in the federal deficit.

The facts are clear:

• Lawmakers’ fiduciary duty is to serve the best interests of Ohio and its residents, not to assert their ideological purity with a pointless stance. Ohio’s best interests lie in accepting the $13 billion in federal money that expansion would bring, and in saving money that, absent expansion, the state is required to spend on prisoners’ health care and other items. The best interests of 275,000 people lie in having health-care coverage.

• Failing to expand Medicaid will hurt every Ohio hospital. Not only will it mean more patients unable to pay, but federal funds that up to now have partly compensated hospitals for charity care will shrink, because the health-care law expects states to accept the Medicaid expansion. At large research hospitals, such as Ohio State University’s Wexner Medical Center and the University of Cincinnati Medical Center, the financial hit would diminish the capability for critical medical research. This, in turn, hurts Columbus and other cities where the health-care industry plays an important economic role.

• Ohio is especially well positioned for Medicaid expansion, because of the excellent work already done to reform the program by state Medicaid Director John McCarthy and Greg Moody, director of the Governor’s Office of Health Transformation. They’ve lowered costs and improved coordination of care, and have put efficient systems in place that should help expansion unfold smoothly.

• Depriving poor people of medical insurance doesn’t even save money. Because no one can be denied needed medical care, people without health insurance still will receive treatment at hospitals. To pay for it, the costs will be passed on to those who do have insurance, in the form of higher premiums. This will hit employers who provide health insurance, their employees and anyone who buys health insurance individually.

There still is time to enact the expansion. Polls have shown a majority of Ohioans want expansion, and there probably are enough votes in the legislature to pass it.

House Speaker William G. Batchelder and Senate President Keith Faber have an obligation to bring the issue to a vote in each chamber so that Ohioans can see who goes on the record for expansion and who stands against it.